Football Players' Tendons Can't Handle Lockout

After an extended off-season due to a four-month lockout, professional football players tore their Achilles tendons at unprecedented rates.

THE GIST

The rate of Achilles tendon ruptures in NFL players is much higher than normal this year following a four-month lockout.

Bones, tendons, ligaments and joints can all suffer if athletes fail to prepare their bodies for high-intensity sports.

Researchers are watching as NBA players resume competition in the next few weeks after a five-month lockout.

Returning to the football field after a four-month lockout late last summer may have led to an unprecedented number of injuries for NFL players.

The findings raise concerns about what will happen to professional basketball players in the coming weeks as they return from a lockout of their own.

In just the first two weeks of preseason football training this year, according to a new study, the league reported more Achilles tendon ruptures than normally occur an entire season. To date, the number of Achilles ruptures in professional football players is between two and five times higher than normal.

That uptick in soft tissue injuries is a testament to the value of a lengthy preseason, said Timothy Hewett, director of sports medicine research at Ohio State University Medical Center in Columbus. Players usually spend months under the watchful eyes of coaches, physical therapists, trainers and sports medicine physicians who guide them through specific exercises that prepare their bodies to withstand the extreme physical demands of professional athletics.

"As you can imagine, these NBA players make enormous sums of money, tens of millions of dollars a year or more," Hewett said. And basketball teams are much smaller than football teams, so there's a bigger potential impact from a season-ending injury in a single player.

"There's a lot of angst about this," he said. "If it happened in the NFL, could it happen in the NBA?"

For an 18-week period beginning in March, professional football players were locked out by team owners as the two groups haggled over a 10-year revenue deal. When athletes finally started practicing again at the end of July, they had just over two weeks of training camp before preseason games began. Most years, training camps last for 14 weeks.

That extra-long break may have set the unconditioned athletes up for injury, Hewett and colleagues wrote in the Journal of Orthopaedic & Sports Physical Therapy. In the first 12 days of training camp this year, 10 players ruptured their Achilles tendons, followed by two more in the next 17 days.

Overall, Hewett said, the league has seen 20 Achilles ruptures since the start of the season -- compared to a total tally of between four and 10 Achilles tears over the course of a typical 24-week season. Between one and three Achilles ruptures normally happen during the preseason, the researchers estimated, which means that this year's early-season cluster of injuries was four times higher than normal.

Achilles tendon ruptures normally strike veteran players who have been playing in the NFL for an average of six years, according to data on the 31 ruptures that happened in the league from 1997 to 2002. But this season, half of the preseason tears occurred in rookies with an average of just over one year of experience -- suggesting that a lack of conditioning was like a great equalizer for injury potential.

Torn Achilles injuries, which usually happen after an athlete lands on one foot with more force than the tendon can handle, are career-ending injuries for a third of the players who sustain them. Those who do return to competition face nearly a year of rehab.

Even though scientists can't prove that the extended NFL lockout caused this season's high rate of injuries, the new study lends support to what athletes and coaches already know. To avoid injuries, it is essential to prepare your body in sport-specific ways -- whether you're an elite football star or a middle-aged weekend warrior who plays pick-up basketball or soccer.

"One of the reasons people tear their Achilles is that they are sedentary or relatively sedentary and then they step up the intensity," said Bert Mandelbaum, an orthopedic surgeon in Santa Monica, team physician for several Major League Soccer teams, and director of research for Major League Baseball. "Tendons just can't handle that level of stress."

And it's not just the Achilles that can blow when put into a high-pressure situation, Mandelbaum said. Bones, ligaments and tendons in the knees and elsewhere are all vulnerable to forces that they're not prepared for.

On the flip side, he said, our bodies have an amazing ability to adapt to extra loads when put through a gradual and comprehensive workout program that includes attention to strength, agility, coordination, aerobic fitness, balance and neuromuscular control.

Ballistic plyometric exercises, which involve high-intensity jumping, can be particularly helpful, Hewett said -- reducing the risk of joint, ligament and tendon injuries by as much as 50 to 60 percent.

Only time will tell if members of the NBA have prepared well enough during their unexpected time off. After a five-month lockout, a shortened and condensed basketball season will begin on Christmas Day.